title: Comparison of sevoflurane versus propofol under auditory evoked potential monitoring in female patients undergoing breast surgery.
abstract: BACKGROUND
  General anesthesia is used for most major surgeries, and the most common side effects include headache, nausea, vomiting, and sore throat. Major breast surgery is associated with a high incidence of postoperative nausea and vomiting (PONV). We compared the postoperative nausea and vomiting of propofol-based total intravenous anesthesia (TIVA) and sevoflurane (SEVO) anesthesia under auditory evoked potential (AEP) monitoring in female patients undergoing breast surgery.
  
  
  METHODS
  A total of 84 patients scheduled to undergo elective breast surgery from 1 to 4 h in duration from March 2011 to December 2011 were prospectively included in the study. All participants were randomly assigned to TIVA or SEVO group. The AEP index was maintained at 15-25. After completing the surgery, the duration of surgery, emergence time, and the side effects of PONV were recorded.
  
  
  RESULTS
  Patient characteristics, intraoperative and postoperative data, and the amounts of intraoperative analgesic drugs used were not significantly different between the TIVA and SEVO groups. The incidence of PONV was significantly higher in the SEVO group than in the TIVA group (50% and 14.3%, respectively; p < 0.001), and the total cost was significantly lower in the TIVA group than in the SEVO group (648 ± 185 and 850 ± 197, respectively).
  
  
  CONCLUSIONS
  We observed that when compared with sevoflurane, propofol given for the maintenance of general anesthesia improves the postoperative patient well-being and reduces the incidence of PONV. Furthermore, total intravenous anesthesia with propofol resulted in significant cost reductions.
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Hsiu-Pin
authors.initials: HP
authors.lastname: Chen
authors.forename: Ya-Hui
authors.initials: YH
authors.lastname: Hsu
authors.forename: Kuo-Chun
authors.initials: KC
authors.lastname: Hua
authors.forename: Chih-Chung
authors.initials: CC
authors.lastname: Lin
authors.forename: Yung-Feng
authors.initials: YF
authors.lastname: Lo
authors.forename: Huang-Ping
authors.initials: HP
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D001940:Breast / Q000601:surgery*; D005072:Evoked Potentials, Auditory; D005260:Female; D006801:Humans; D015994:Incidence; D008738:Methyl Ethers / Q000494:pharmacology*; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology*; D015742:Propofol / Q000494:pharmacology*; D011446:Prospective Studies; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol